Midtown Manhattan 36 W 44th St Ste 914 New York, NY 10036

Patient Forms

Completing the proper medical forms, is necessary during your initial consultation with pain management New York specialist Dr. Melepura. Below, you may find links to our Patient Forms you may simply click on the desired form, print the form, complete each field, and bring these forms with you on the day of your scheduled appointment. We look forward to meeting you when you visit New York pain specialist Dr. Melepura of pain management clinic in NYC.

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In addition to bringing these completed forms to your initial appointment, also bring:

  • Any pertinent Medical Records, including any previous (if any) xrays and reports you may have had done
  • A list of current medications
  • Insurance Cards
  • Co-Payment – if your insurance company requires one, we are required by them to collect this payment at the time of service – You may pay by Visa/Mastercard credit or debit card or check

Our pain management clinic in New York works with most insurances and utilizes patients’ out-of-network benefits. For more information about the insurance coverage, patient forms or treatments offered at the NYC pain clinic please contact our Midtown office.

Sports Injury & Pain Management Clinic of New York
36 W 44th St Ste 1100
New York, NY 10036
(212) 621-7746
(Between 5th & 6th Ave)

This page was published on Feb 5, 2019, modified on Jan 6, 2021 by Dr. Melepura (Pain Management Doctor) of Sports Injury & Pain Management Clinic of New York Sports Injury & Pain Management Clinic of New York
36 W 44th St #914
New York, NY 10036
(212) 621-7746
DISCLAIMER: PLEASE READ CAREFULLY
The information on this website is to provide a general information. In no way does any of the information provided reflect a definitive treatment advice. It is important to consult a best in class pain physician regarding ANY questions or issues. A thorough evaluation should ALWAYS be performed for an accurate diagnosis and treatment plan. If you are in pain or need help be sure to call your local doctor or Dr. Melepura in Midtown Manhattan, to schedule a consultation.
Sports Injury and Pain Management Doctor NYC - Febin Melepura MD

Febin Melepura MD is a top rated, best in class interventional pain management doctor. He is a nationally recognized pain relief specialist and is among the top pain care doctors in New York City and the country. He is an award winning expert and contributor to a prominent media outlets.

Dr. Febin Melepura has been recognized for his thoughtful, thorough, modern approach to treating chronic pain and, among other accolades, has been named a “top pain management doctor in New York”, and one of “America’s Top Doctors™” for an advanced sports injury treatments.

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